Behavior Problems in Toddlers Linked to Parental Prenatal Stress

Emotional and behavioral problems in 2 year olds may be connected to the emotional difficulties experienced by expectant parents, according to new research. The study suggests that stress and conflict may be a serious contributor to the creation of “difficult” toddlers.

The research team, made up of researchers from the Universities of Cambridge, New York, Birmingham and Leiden believe their findings point to a serious need for more support for couples before, during and after pregnancy to improve outcomes for kids. The study was published in Development & Psychology and reviewed the experiences of 438 first-time expectant mothers and fathers from Eastern England, New York State and the Netherlands. The teams followed up with the couples at 4, 14 and 24 months after birth.

It’s the first study to look at the influence of both mothers’ and fathers’ well-being before and after birth on the adjustment and behavior of children at 14 and 24 months of age.

Lead author, Professor Claire Hughes from Cambridge’s Centre for Family Research, said: “For too long, the experiences of first-time dads has either been side-lined or treated in isolation from that of mums. This needs to change because difficulties in children’s early relationships with both mothers and fathers can have long-term effects.

“We have already shared our findings with the NCT (National Childbirth Trust) and we encourage the NHS and other organisations to reconsider the support they offer.”

Researchers discovered that the prenatal well-being of first-time mothers had a direct impact on the behavior of their children as 2 year olds. Higher stress and anxiety levels during the prenatal period on the part of the mother were more likely to result in children with behavioral issues like temper tantrums, restlessness and spitefulness.

The researchers also found that two-year-olds were more likely to exhibit emotional problems — including being worried, unhappy and tearful; scaring easily; or being clingy in new situations — if their parents had been having early postnatal relationship problems. These ranged from a general lack of happiness in the relationship to arguments and other kinds of conflict.

Hughes says: “Our findings highlight the need for earlier and more effective support for couples to prepare them better for the transition to parenthood.”


While links between child behavioral outcomes and parental well-being have been revealed in other studies, this is the first study to involve couples, to track parental well-being in both parents over an extended period of time and to focus on child behavior in the first two years of life. There is growing evidence of the importance of mental health support for expectant and new mothers. This study goes further to support the idea of extending that same type of support to expectant fathers. It’s also the first to reach beyond the well-being of mothers and fathers as individuals and to consider the quality of the relationships of new mothers and fathers as couples.

The researchers acknowledge that genetic factors are likely to play a role but they accounted for parents’ mental health difficulties prior to their first pregnancy and after their child’s birth. Co-author Dr Rory Devine, a developmental psychologist at the University of Birmingham, says “Our data demonstrate that mental health problems during pregnancy have a unique impact on children’s behavior problems.”

Using standardized questionnaires and in-person interviews, participating mothers and fathers reported on their symptoms of anxiety and depression in the third trimester of pregnancy and when their child was 4, 14 and 24 months old. At each of these visits, parents also completed standardized questionnaire measures of couple relationship quality and children’s emotions and behavior.

Hughes says: “There has been an assumption that it’s really difficult to get dads involved in research like this. But our study draws on a relatively large sample and is unique because both parents answered the same questions at every stage, which enabled us to make direct comparisons.”

The research is part of an ongoing project examining the well-being and influence of new mothers and fathers. In a closely linked study, published in Archives of Women’s Mental Health in July 2019, the team found that fathers share in traumatic memories of birth with their partners far more than has previously been recognised. This study compared the well-being of parents in the third trimester of pregnancy with that when their child was four months old.

Co-author, Dr Sarah Foley, also from Cambridge’s Centre for Family Research said: “If mum has a difficult birth, that can be a potentially traumatic experience for dads.”

“What both studies show is that we need to make antenatal support much more inclusive and give first-time mums and dads the tools they need to communicate with each other and better prepare them for this major transition. With resources stretched, parents are missing out on the support they need.”

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Journal Reference – Claire Hughes, Rory T. Devine, Judi Mesman, Clancy Blair. Parental well-being, couple relationship quality, and children’s behavioral problems in the first 2 years of life. Development and Psychopathology, 2019

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